Abstract:

Objective　To analyze the application value of magnetic resonance three-dimensional artery spin labeling (3D ASL) combined with three-dimensional time-of-flight magnetic resonance angiography (3D-TOF MRA) in evaluating the cerebral perfusion status after unilateral internal carotid artery (ICA) chronic occlusion. Methods　A retrospective study was conducted on 40 patients with unilateral ICA occlusion admitted to the Department of Encephalopathy of Nanjing University of Chinese Medicine Affiliated Lianyungang Hospital from January 2018 to March 2022, including 24 males and 16 females, with an age of (52.4±16.9) years old. Routine MRI sequence, 3D ASL, and 3D TOF MRA sequence were performed for all patients, with the 3D ASL post label delay (PLD) of 2 525 ms. According to whether the anterior communicating artery (ACoA) and posterior communicating artery (PCoA) were opened and whether the anterior cerebral artery (ACA) and posterior cerebral artery (PCA) were laterally dominant howed by the 3D TOF MRA sequence, they were divided into a collateral circulation group and a control group. The cerebral blood flow (CBF) values of frontal lobe, parietal lobe, temporal lobe, paraventricular white matter area, and basal ganglia area were measured by CBF pseudo color map. Two independent sample t-test was performed. Results　Among the enrolled patients, there were 22 cases of left ICA occlusion and 18 cases of right ICA occlusion. The CBF values of frontal lobe, parietal lobe, temporal lobe, paraventricular white matter area, and basal ganglia area in the collateral circulation group were (42.14±6.75) ml/min×100 g, (41.47±6.91) ml/min×100 g, (42.85±7.14) ml/min×100 g, (36.82±7.06) ml/min×100 g, and (37.87±7.25) ml/min×100 g, which were higher than those in the control group [(32.09±7.25) ml/min×100 g, (31.16±7.32) ml/min×100 g, (32.53±7.56) ml/min×100 g, (29.37±6.27) ml/min×100 g, and (28.45±6.87) ml/min×100 g], with statistically significant differences (all P<0.05). Conclusion　3D ASL combined with 3D TOF MRA can be used to evaluate the establishment of collateral circulation and cerebral perfusion after unilateral ICA occlusion, and can provide imaging basis for patients' clinical treatment options and prognosis evaluation.

Key words:

Internal carotid artery, Collateral circulation, Arterial spin labeling, Cerebral blood flow

摘要：

目的　分析磁共振三维动脉自旋标记（3D ASL）联合三维时间飞跃法磁共振血管成像（3D-TOF MRA）技术在评估单侧颈内动脉（ICA）慢性闭塞后脑灌注状态的应用价值。方法　回顾性研究2018年1月至2022年3月南京中医药大学连云港附属医院脑病科收治的单侧ICA闭塞患者40例，其中男24例，女16例，年龄（52.4±16.9）岁。均行常规MRI序列、3D ASL及3D-TOF MRA序列检查，3D ASL标记后延迟时间（PLD）2 525 ms，依据3D-TOF MRA序列显示有无前交通动脉（ACoA）及后交通动脉（PCoA）开放、大脑前动脉（ACA）及大脑后动脉（PCA）偏侧优势分为侧支循环组（23例）和对照组（17例）。通过脑血流量（CBF）伪彩图分别测量额叶、顶叶、颞叶、脑室旁白质区以及基底节区CBF值。行两独立样本t检验。结果　入组患者中，左侧ICA闭塞22例，右侧ICA闭塞18例。侧支循环组额叶、顶叶、颞叶、侧脑室旁白质区及基底节区CBF值分别为（42.14±6.75）ml/min×100 g、（41.47±6.91）ml/min×100 g、（42.85±7.14）ml/min×100 g、（36.82±7.06）ml/min×100 g、（37.87±7.25）ml/min×100 g，均高于对照组的（32.09±7.25）ml/min×100 g、（31.16±7.32）ml/min×100 g、（32.53±7.56）ml/min×100 g、（29.37±6.27）ml/min×100 g、（28.45±6.87）ml/min×100 g，差异均有统计学意义（均P<0.05）。结论　磁共振3D ASL联合3D-TOF MRA技术，可用于评估单侧ICA闭塞后侧支循环建立及脑灌注状态，为患者临床治疗方案选择以及预后评估提供影像依据。

关键词:

颈内动脉, 侧支循环, 动脉自旋标记, 脑血流量